Social-cognitive factors mediating intervention effects on handwashing: a longitudinal study

Abstract

Handwashing with soap effectively prevents diarrhoea, a leading cause of death in infants. Theory-based interventions are expected to promote handwashing more successfully than standard approaches. The present article investigates the underlying change processes of theory-based handwashing interventions. A nonrandomised field study compared a standard approach to two theory-based interventions that were tailored to the target population, the inhabitants of four villages in southern Ethiopia (N = 408). Data were collected before and after interventions by structured interviews and analysed by mediation analysis. In comparison to the standard approach (i.e., education only), education with public commitment and reminder was slightly more effective in changing social-cognitive factors and handwashing. Education with an infrastructure promotion and reminder was most effective in promoting handwashing through enhancing social-cognitive factors. The results confirm the relevance of testing interventions' underlying change processes.

Approaches to promote handwashing and sanitation behaviour change in low‐ and middle‐income countries: a mixed method systematic review

“…The remaining studies were judged to be of moderate (1) and serious (3) bias. Andrade, 2013Arnold et al, 2009Contzen et al, 2015aDickey et al, 2015Kochurani et al, 2009Pinfold, 1999Seimetz et al, 2016Waterkeyn & Cairncross, 2005Younes et al, 2015 green: low; yellow: no information; orange: moderate; red: serious; dark red: critical…”

“…In this way, the effect of specific additional elements to a promotional approach could be studied. We discuss the different comparisons below (Contzen et al, 2015a(Contzen et al, /2015bDickey et al, 2015;Graves et al, 2011;Guiteras et al, 2015a;Lhakhang et al, 2015;Zhang et al, 2013).…”

“…Taken together, we identified 46 references to quantitative studies (individual quantitative and mixed-methods studies), and 28 references to qualitative studies (individual qualitative and mixedmethods studies). For the quantitative papers published by Contzen et al (2015a and, Galiani et al (2012 and, and Patil et al (2013 and, two separate references (with complementary information) for each study were included resulting in a total number of 41 quantitative studies (from 45 references). The study selection flowchart can be found in Figure 3.…”

Contextual and Psychosocial Determinants of Effective Handwashing Technique: Recommendations for Interventions from a Case Study in Harare, Zimbabwe

“…The RANAS model has been successfully applied to predict and change the frequency of handwashing at key handwashing situations in several countries. [24][25][26][27] Taken together, washing hands with an effective technique is recommended by various institutions. However, what drives individuals to do so or prevents them from actually applying effective handwashing techniques remains largely unknown.…”

Continuation of Health Behaviors: Psychosocial Factors Sustaining Drinking Water Chlorination in a Longitudinal Study from Chad

“…Behavior change strategies based on psychosocial surveys which are tailored to the local populations' mindsets have been shown to outperform standard approaches, which often only address risk awareness and a few other factors such as knowledge of disease prevention [13]. Several factors at the personal and social level-such as social norms, status, self-efficacy convictions, and the like-have been shown to be important predictors for the success of promotion campaigns targeting a range of health-relevant behaviors [14][15][16][17].…”